Retinal toxicity from Hydroxchloroquine

[Stony180]

A Rhumatologist I am seeing is considering putting me on Hydroxchloroquine for an arthritic condition but I am extremely concerned about retinal toxicity. From what I've read it was initially thought that the toxicity usually started at around the 5 year mark but I've read some studies that suggest that this could occur sooner. Also, I think deposits in the cornea can sometimes be detected after only a brief time on the drug. Preexisting retinal disease can also be a risk factor I read. Two years ago I had a PVD that caused a retinal tear and the Retina Specialist noted at that time I had some lattice degeneration. I don't know if those things would be considered preexisting retinal disease or not. I would appreciate any advice. I never would have guessed that I might have to risk my sight just to treat arthritis.

[John C Hagan III, MD, FACS, FAAO]

Hydrochloroquine (HCQ) or Plaquenil  is one of the cornerstones of treating autoimmune disease.  It is used when lesser drugs won't work. It can prevent serious incapacitation, even disablity and death.  No drug is without side effects.  Thousands die every year from bleeding to death from aspirin.  HCQ toxicity is rare given the number of people that take it.  Toxicity is often related to mgm drug to Kg of body weight. This most people that have the problem are very thin (not typical american size) (less 120 lbs) and take a large does (more than 400 mgm/day) and have been on the medication for longer than 5 years.  PVD, Lattice and previous retinal tear would not increase your risk from taking the medication.  You can continue to see your retina MD once or twice per year with exam and macular OCT and Macular pseudofloresence  and if toxicity develops in most people it clears or does not progress when the medication stops.